Stroke
[
en Español]
What is a stroke?
A stroke is when a clogged or burst artery interrupts blood
flow to the brain. This interruption of blood flow deprives the
brain of needed oxygen and causes the affected brain cells to
die. When brain cells die, function of the body parts they
control is impaired or lost.
A stroke can cause paralysis or muscle weakness, loss of
feeling, speech and language problems, memory and reasoning
problems, swallowing difficulties, problems of vision and visual
perception, coma, and even death.
What physical and emotional problems occur after a stroke?
Common warning signs of a stroke include the following:
- sudden numbness or weakness of the face, arm and/or
leg
- sudden confusion, trouble speaking, or difficulty
understanding speech
- sudden difficulty seeing in one or both eyes
- sudden trouble walking, dizziness, loss of balance, or loss
of coordination
- sudden severe headache with no known cause
If you or anyone you know experiences any of the above warning
signs, call your doctor or go to an emergency room
immediately.
Because of the organization of our nervous system, an injury
to one side of the brain affects the opposite side of the body.
Often the person loses movement and/or feeling in the arm and/or
leg opposite the side of the brain affected by the stroke. So, if
a person has a stroke on the left side of the brain, he or she
may have weakness or paralysis in the right arm and leg. This
makes it difficult for the person to perform activities of daily
living (e.g., dressing, feeding, bathing, tying shoes, etc.). It
is also common for survivors of stroke to tire easily.
After a stroke, a person may be able to see objects in only
certain parts of his or her field of vision. Visual perception of
everyday objects may also change. Objects may look closer or
farther away than they really are, causing the person to spill at
the table or bump into things while walking. Some people may lose
awareness of their weaker side and ignore or forget about it. As
a result, they may have trouble reading because they only see
half of the page. They may only dress one side of their body
thinking they are fully dressed. This one-sided neglect is most
common when there is damage to the right hemisphere of the
brain.
Stroke survivors often show inappropriate emotions and extreme
mood fluctuations. They may laugh when something isn't funny
or cry for no apparent reason. This is particularly common early
on in the recovery process.
Persons who have had a stroke may seem very self-absorbed.
They may demonstrate an intense need for a structured, unchanging
routine. They may be very frustrated with their inability to
communicate effectively, and this may lead to anger and
depression.
What communication problems occur after a stroke?
After a stroke, some people experience language deficits (
aphasia
) that significantly impair their ability to communicate. These
deficits vary depending on the extent and location of the damage.
Read a
detailed
discussion of aphasia.
Deficits in
social communication skills
(
pragmatics
) may result in the following:
- Difficulty sequencing thoughts together to tell a
story
- Switching topics without warning, or seeming to "go
off on tangents" without informing the listener
- Difficulty taking turns in conversation
- Problems maintaining a topic of conversation
- Trouble using an appropriate tone of voice
- Difficulties interpreting the subtleties of conversation
(e.g., sarcasm, humor)
- Problems "keeping up" with others in a fast-paced
interaction
- Reacting inappropriately; seeming overemotional
(overreacting), impulsive, or "flat" (without
emotional affect)
- Having
little to no self-awareness
of inappropriate actions or responses
Oral motor functioning
is sometimes affected by a stroke. The following problems may
occur:
- Muscles of the lips and tongue may be weaker (
dysarthria
) or less coordinated (
apraxia
).
- Speech may not be clear.
- Breathing muscles may be weaker, affecting the
patient's ability to speak loudly enough to be heard in
conversation.
Muscles may be so weak that the person is unable to speak;
consequently, he or she may need augmentative or alternative
communication aids to help express ideas (e.g., a communication
board).
Weak muscles may also limit the ability to chew and swallow
effectively (
dysphagia
). Read a
detailed
discussion of swallowing problems.
What cognitive problems occur after a stroke?
Cognition
refers to thinking skills. Cognitive difficulties are common in
people who have had a stroke on the right side of the brain, and
they vary in seriousness depending on the location and severity
of the damage. The following problems may occur:
- Not being aware of one's surroundings
- Poor attention to tasks
- Memory difficulties
- Poor reasoning skills
- Poor problem solving skills
- Poor
executive functioning
(e.g., goal setting, planning, initiating, self-awareness,
self-inhibiting, self-monitoring and evaluation, flexibility of
thinking)
-
Trouble concentrating
when there are internal and external distractions (e.g.,
carrying on a conversation in a noisy restaurant, dividing
attention among multiple tasks/demands)
-
Slower processing
of new information
-
Recent memory
is affected in some people, making new learning difficult. For
example, some people may have trouble learning the new things
they are being taught, such as how to get in and out of their
wheelchair safely.
How is a stroke diagnosed?
A stroke is diagnosed by medical professionals. Special tests
that allow doctors to look at the person's brain (CT scan,
MRI) are often used to determine where the stroke occurred and
how severe it is.
A speech-language pathologist (SLP) works with other
rehabilitation and medical professionals and families to provide
a comprehensive evaluation and treatment plan for stroke
survivors. The team may include:
- doctors
- nurses
- neuropsychologists
- occupational therapists
- physical therapists
- social workers
- employers/teachers (when applicable)
To contact a speech-language pathologist, visit ASHA's
Find a Professional.
What other organizations have information about a stroke?
This list is not exhaustive and inclusion does not imply
endorsement of the organization or the content of the Web site
by ASHA.
Return to Top
See Also: